Neonatal care in hospital
Special care for babies is sometimes provided on the ordinary postnatal ward and sometimes in a specialist newborn (neonatal) area.
Having a baby in neonatal care can be worrying, but the staff looking after your baby should make sure you receive all the information, communication and support you need.
Not all hospitals provide specialist neonatal services, so your baby may be transferred to another hospital if they need special care.
Why babies need special care
Your baby could be admitted to neonatal care for a number of reasons, including when they:
- are born early (premature)
- are very small and have a low birthweight
- have an infection
- have jaundice
- had a very difficult birth
- are waiting for, or recovering from, complex surgery
Touching and holding your baby
The special care baby unit may seem strange and confusing at first, especially if your baby is in an incubator or on a breathing machine. There may also be tubes and wires attached to their face and body.
Ask the nurse to explain what everything is for and show you how you can be involved in your baby's care. You may be able to change your baby's nappy, wash them and change their clothing.
Once your baby is stable, you'll be able to hold them. The nurses will be able to help you take your baby out of the incubator and show you how to have skin-to-skin contact.
Your baby will benefit greatly from physical contact with you. You can talk to your baby as well – this can help both of you.
You should wash your hands carefully and dry them thoroughly before touching your baby.
Feeding
To begin with, your baby may be too small or too sick to feed themselves. You can express some of your breast milk, which can be given to your baby through a tube.
A fine tube is passed through their nose or mouth into their stomach. This will not hurt them.
Talk to a midwife at the hospital about how you can express breast milk for your baby. The hospital may have breast pumps you can use.
Your milk has particular benefits, especially if your baby is sick or premature, as it's enriched with proteins (such as antibodies), fats and minerals.
If your baby is not able to have your milk to begin with, the milk can be frozen and given to them when they're ready.
When you go home, you can express milk for the nurses to give while you're away. There's no need to worry about how much milk you produce – every bit helps your baby.
Incubators
Babies who are very small are nursed in incubators rather than cots to keep them warm. You can still have a lot of contact with your baby.
Some incubators have open tops, but if your baby's incubator does not, you can put your hands through the holes in the side of the incubator to stroke and touch them.
Newborn babies with jaundice
Jaundice in newborn babies is common. Jaundice will make the whites of their eyes and their skin look a bit yellow, although yellowing of the skin can be more difficult to see on brown or black skin.
Babies with severe jaundice may be treated with light therapy (phototherapy). The baby is undressed and put under a very bright light, usually with soft eye pads or a special box over their head to protect their eyes.
The special light helps break down the chemical that causes jaundice. It may be possible for your baby to have phototherapy by your bed in the postnatal ward so you do not have to be separated.
Light treatment may continue for several days, with breaks for feeds, before the jaundice clears up. Sometimes, if the jaundice gets worse, your baby may need a blood transfusion. This is not common.
Some babies have jaundice because of liver disease and need different treatment. A blood test that checks for liver disease is done before phototherapy is started.
Find out more about how newborn jaundice is treated.
Babies with jaundice after 2 weeks
Many babies are jaundiced for up to 2 weeks after they're born, or 3 weeks in premature babies.
It's more common in breastfed babies and does no harm. It's not a reason to stop breastfeeding.
If your baby is still jaundiced after 2 weeks, tell your GP, midwife or health visitor the same day, especially if their poo is chalky white or they have dark pee. This can indicate a liver problem.
A blood test will distinguish between jaundice that will go away by itself and jaundice that may need urgent treatment.
Babies with disabilities
If your baby is disabled, talk to people about how you feel, as well as about your baby's health and future.
Your GP, a doctor for newborn babies (neonatologist), a children's doctor (paediatrician) or your health visitor can all help you.
You can also contact the hospital Patient Advice and Liaison Service (PALS), or your social services department for information about local organisations that may be able to help.
Find your local authority on GOV.UK
The organisations listed here can offer help and advice:
- Bliss – offer advice for parents of premature and sick babies, including looking after your mental health
- Contact – for families with disabled children
- Living made easy – for advice on all types of daily living equipment for disabled adults and children
- Genetic Alliance UK – supporting those affected by a genetic condition
- Group B Strep Support – preventing group B strep infection in newborn babies
- Peeps – for those affected by hypoxic-ischaemic encephalopathy (HIE)
- Mind – for better mental health
Talking to other parents with similar experiences can also often help.
Worries and explanations
Hospital staff should explain what kind of treatment your baby is being given and why. If they do not tell you, ask them.
It's important that you understand what's happening so you can work together to make sure your baby gets the best possible care.
Some treatments need your consent to go ahead, and the doctors will discuss this with you.
It's natural to feel anxious if your baby needs special care. Talk over any fears or worries with the hospital staff. Hospitals often have their own counselling or support services, and a number of charities run support and advice services.
The consultant neonatologist or paediatrician should arrange to see you, but you can also ask for an appointment at any time if you wish.
The hospital social worker may be able to help with practical issues, such as travel costs or help with looking after children.